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Fellow parents who do biomed, or are familiar with Martin’s diet, like to ask me what Martin eats for breakfast. Deep in our psyche sits a notion that breakfast, especially a kid’s breakfast, must involve cereal, porridge, toast, muffin, eggs, and milk or yogurt, and we seem to have trouble fathoming breakfast for a kid who eats none of those except eggs, which he really doesn’t like.

My idea of “breakfast foods” has expanded in our seven years of biomed. I decided to snap pictures—I know I’m not much of a food photographer, especially when I have only five-to-seven seconds before Martin sits and starts eating—and assemble a breakfast post.

Without further ado, I present seven samples of Martin’s breakfast:

Fritters are always a popular choice. These were made with leftover spiced red beans, flattened and fried. The fritters are joined by pineapple and a green smoothie of cashew milk, coconut yogurt, dates, banana, peanut butter, and spinach.

More fritters, this time zucchini and egg with carrot greens. The smoothie is coconut milk, dates, spinach, and moringa powder.

Hands down, Martin’s favorite breakfast food is smoked salmon. Now that I’ve learned that freezing below -10 degrees Fahrenheit for a few days renders the fish safe (in terms of parasites), I’ve allowed salmon back on the menu. Here is is served with sweet potato hash browns. The smoothie is cashew milk, coconut yogurt, banana, almond butter, and spinach.

If I want to make sushi for breakfast, I will make sushi for breakfast. Here, I packed the short-grain rice into a silicon “mini-donut” mold, filled the middle with mashed avocado, then wrapped the packet in nori seaweed and sliced salmon, then rolled the still-exposed rice in sesame seeds.

This was prepared most for Adrian (Saturday morning, pre-gym) and made him much happier than it made Martin. Bacon and vegetables under a shredded sweet potato fritter, topped with fried egg. I absolutely detest cooking pig meat. Few things make Adrian happier than bacon.

This is unusual, thrown together when we were running late. On the plate are almond-flour English muffins with a thin coating of maple butter. The smoothie is coconut milk, kale, banana, and avocado.

That pesky salmon again! This time with a side of garlic broccoli. The smoothie has almond milk, coconut yogurt, leftover white beans (really), matcha green tea powder, frozen banana, and salad greens.

Salmon. It is a lot of salmon. Fried potato and sweet potato with rosemary. Black-rice toast. The smoothie is coconut water with pineapple, banana, mango, and avocado.

This was a plate I assembled last week while we were traveling in England. The breakfast comprises cold shrimps, pineapple, and red lentils with vegetables. In the wooden spoon are Martin’s breakfast pills. In the smaller glass is his morning “herx water.”

An old friend texted me, asking a favor. The two-year-old son of one of his law partners was just diagnosed with autism. Would I consider having lunch with the man, share with him our experiences?

No problem, I responded. The school/services/therapy side, or the biomed side?

Friend texted: “I told him about the dietary approach you took. Don’t know if they’re ready for that level of discipline but would be good for him to hear.”

“Dietary approach.” Love it.

I texted: “Over the years I’ve learned to approach the newbies gently, and tell them only what they’re ready to hear (plus maybe a little more).”

I have these types of meetings from time to time: friend-or-a-friend arrangements during which, depending on the direction the conversation takes, I tap, nudge, or shove the parents in the biomed direction. “Absolutely,” said Adrian, when I told him about the arranged lunch. It was one more opportunity to show our gratitude for Martin’s recovery thus far—that is, to imagine what our lives would be like today if we still had a son who postured because of gut pain, could not sleep unassisted, and neither acknowledged nor seemed to recognize his own parents.

Six years ago, I wrote about how my family got into biomed, in a series of three posts titled “The A-ha Moment.” Part I described our first realization that autism is medical and recovery may be possible. Part II told how a business contact of Adrian put us in touch with another contact whose wife, Annie, had recovered their son and was willing to talk to me. (A more precise description would be: “whose wife had recovered their son and was willing to spend a ton of time (seriously, an hour to start, and then hours more in follow-up) on the phone with me.”) Part III narrated—

Well, holy crap. In reviewing my blog in order to write this post, I’ve just realized that I never wrote “The A-ha Moment: Part III.” Me acabo dar cuenta de que soy una idiota. I thought I wrote it. I was sure I wrote it! Evidently, I never did. (In my defense, six years ago, I slept very little.) This situation must be remedied. I’ve rummaged through my home office and found the notes of the conversation back in January 2011 on which I intended to base Part III. Without further ado, I present The A-ha Moment: Part III:

The background. “You’ve got to talk to Betty [a pseudonym],” said my then-sister-in-law after Martin was diagnosed. “Her son has autism, and he’s doing amazing.”

I’d met Betty once, ten years earlier at my brother and sister-in-law’s house, when she and her husband brought over their two kids, a girl of about four and a toddler boy. I remembered the boy only vaguely. He’d run around and got into everything, like toddlers do.

I asked my sister-in-law to put me in touch with Betty. We scheduled a phone call, which took place the day after Annie had told me about recovering her son biomedically.

The conversation. I opened the Betty call by explaining that our son was undergoing formal diagnosis but that it was clear that he had autism, and that although we already had him in Early Intervention with ample therapy, we thought there was more we could do, medically.

“Oh, I’m probably not the best one to ask about that side of things,” Betty said. “We didn’t go in for the diet-and-supplementation stuff.”

No?

Betty explained that they had started biomed with their son—which, subsequently, I realized was kind of amazing, because this would have been years earlier, and everything was still pretty cutting-edge even when we started with Martin—but had given up quickly. “The diet was impossible. It just got in the way of all our family activities,” Betty said. Nevertheless, Betty assured me that, despite doing only traditional therapies, their son, now eleven years old, was fine.

Really? Tell me more. I was under the impression that a biomedical approach was necessary to really make progress.

Nope, Betty said. Her son was in a mainstream classroom.

That’s great! How does he relate to the other kids?

He’s able to do the assignments, except when the students pair up or work in groups. He’s not able to work cooperatively, so they let him do those activities alone.

Does he have friends?

Not really. He has one friend. They do a lot together. He doesn’t have any other friends. But he doesn’t care, so why should I? In social situations, he tends to isolate himself. When we’re going to be around other people, we let him bring a portable disc player and earphones to watch a movie.

He’s healthy? He sleeps and eats well?

Yes, he sleeps! No problem there. But his diet is terrible. He has food aversions. I have to send pretzels and potato chips for his school lunch every day, just to make sure he eats something. I feel like people think I’m a bad mother. He loves crunchy texture and salty flavor.

Sports?

No. No sports.

After-school activities?

Video games.

Readers, I’m sure you can imagine that by this point in the conversation I had decided that I did not like Betty’s version of “fine.” The picture she was so dire that I began to doubt my previous call with Annie, who told me about recovering her son. I thanked Betty for her time and insights. She concluded by reminding me that her son was fine and letting me know that my son would also be fine.

The follow-up. As soon as I hung up with Betty, I got back on the phone with Annie. Could she clarify? I asked. When she said her son was “recovered,” what did that mean? Was he quirky? A little bit off, in terms of social skills? Unwilling to eat regular foods, maybe? No, Annie answered. He’s recovered. He looks just like other kids. No one in his current school knows he ever had autism. He plays guitar in a kid-band with his friends. He likes sports.

I continued to press. There must be some difference? Annie seemed to think. Finally she said, “Sometimes when he’s playing basketball and it’s really noisy, he gets a little spacey and I feel like he could pay attention better.” That was it. That was what she came up with. The difference between her son and other children was that sometimes he got a little spacey on the basketball court.

Addendum. It’s not entirely correct to say I never wrote Part III. In a November 2011 post titled “Friendships,” I did reference what occurred in The A-ha Moment, Part III. I wrote: “Another parent once told me, about her eleven-year-old son on the spectrum, ‘He doesn’t have friends except for one. But if he doesn’t care, why should I?’” That came from Betty, about her son who was fine.

Back to 2017. Last week’s lunch with my old friend’s law partner, though peppered with discussion of special-needs preschools and CPSE meetings, steered decidedly in the biomed direction. The man asked science-y questions, which I did my best to answer, and listened to my many self-deprecating observations that began with, “I know this probably sounds a little crazy, and if ten years ago, I’d met today-me, I’d think I was crazy. But I’ve learned a lot about health, the immune system, and how seemingly psychiatric conditions can be tied to the gut . . . .”

Two afternoons later, at Martin’s social-skills playgroup, a mother new to the group overheard another mother and I talking, and asked, “What do you mean, ‘biomed’ and ‘neuroplasticity’? I’m not familiar with any of this.”

I paused, wondering whether I should proceed. Then I said, “This is probably going to sound crazy . . . .”

In the earliest days, I would say, Martin’s diet was one of restriction. No grains, dairy, soy, corn, refined sugar, starchy vegetables, or fruits other than pear and avocado. No colors or sweeteners, no packaged or prepared foods, nothing from a restaurant. My mindset was mired in what he could not eat, and I concocted elaborate replacements for “usual” foods. This was a time of homemade zucchini seed “French fries,” sunflour patties, and duck nuggets; as long as the dish didn’t have any no’s, and seemed vaguely like a familiar food, it was a yes.

At some point, food became easier when I focused on simplicity: fewer replacements and complicated recipes, more limited-ingredient masterpieces.

This summer in Nicaragua, I was able to confirm that fruit doesn’t have to be our enemy anymore—after fruit had been relegated to that role for years by Martin’s tendency to yeast overgrowth. Also, through trial and error, I brought back in some of the higher-salicylate items formerly removed.

Now, back in the States with access to an embarrassing range of organic options, my motto has become: “Every meal, a chance to heal.” Martin is still gluten-, dairy-, soy-, and refined-sugar free, and his food is mostly homemade and organic. But I’m focused less on how to replace what Martin can’t eat and more on how I can pack fat, protein, and nutrients onto his plate while still keeping the meals delicious.

For exemplar purposes, I photographed this morning’s breakfast preparations. These were the ingredients, as I prepared them—

You see orange slices, strawberries, 1/4 avocado, one egg, and a bowl with shredded sweet potatoes and minced onion, garlic, and carrot greens. That’s a lot of vitamin content, plus the healthy fat of avocado and protein of egg. Tell me that you’re asking yourself what kind of lunatic arranges the prepared ingredients in a pattern on her cutting board? Only when I’m operating “for exemplar purposes.” Keep up. Next I whisked the egg in a glass with Himalayan pink salt and stirred it into the sweet potato bowl.

Fritter mixture, now with egg. Ready to fry!

Then I juiced those orange slices in preparation for Martin’s smoothie. Because it so fibrous, orange is one of the few fruits I won’t add whole to a smoothie. I usually use coconut water as the base of Martin’s breakfast smoothie; this morning, I had oranges to use up and so substituted orange juice. I put the orange juice in the Vitamix with the avocado and strawberries. I add avocado to every smoothie, healthy fat that Martin doesn’t taste. (I’m also finding new ways to disguise spinach and kale.)

Getting the pulp out of the oranges.

Finally I formed patties from the shredded-sweet-potato mixture and fried them in olive oil. Breakfast looked like this:

Tropical smoothie with “egg muffin” (diced peppers, parsley, and spices with egg, baked in ramekin) and potatoes with carrot greens.

Tropical smoothie and squash fritters, made with onions and red palm oil for rich color.

I still tend to put Martin’s meat serving—if he has one, on a given day—into his school lunch. Today, lunch was turkey meatballs, filled with peppers and leeks. For dessert, homemade meringues (egg whites, vanilla, arrowroot, maple sugar). For snack, a Lärabar.

Tonight was a slow-cooker dinner. Late morning, I diced whatever “autumn” vegetables were in my fridge, and added late-season tomatoes and herbs from my garden. That mixture went into the Instant Pot, together with red lentils, spices, and vegetable broth.

The dinner ingredients. I had such fun laying out the breakfast ingredients for display that I figured I would continue the trend.

Dinner into the Instant Pot to slow cook.

Of course, not every meal is a vegetable powerhouse. Convenience can play its role. Some mornings, breakfast is a smoothie plus “pizza,” i.e., peanut butter spread between Siete grain-free tortillas and fried in macadamia nut oil.

Now, if a child’s system is damaged and not properly absorbing nutrients, all the raw vegetables in the world won’t necessarily get the healing done; the trick is to find the proper food combinations. We are awaiting new test results to learn more about Martin’s gut today and whether we need to tweak his diet yet again.

They also love their fresh food. Fruits, vegetables. Fish and shrimp and octopi pulled from the ocean and eaten the same day. (I hate that Martin eats octopi.) By now we’ve been able to locate the stands and trucks with the produce we want. Samara has a favorite fish monger and a carnecería for occasional chicken. Virtually nothing is organic, except some newfangled greens and the occasional imported quinoa. I am comforted by the fact that the food is grown locally, where Nicaragua’s stricter stance (than the U.S.) on genetically modified crops also reduces the presence of especially worrisome contaminants like glyphosate.

Martin’s breakfast is usually grain-free pancakes (say, plantains and peanut butter), or fritters, or eggs with vegetables, plus fruit. Dinner is rice and beans, or coconut-crusted chicken nuggets with vegetables, or quinoa pilaf, or peanut-butter stir-fry, or maybe ceviche. (Samara’s ceviche skills are said to be outstanding.)

A Nicaraguan breakfast of plantain-and-peanut-butter fritters plus apple. Did you know apples can be grown in Central America? Neither did I.

Weekdays, Martin eats lunch at his camp. That development—eating with the other kids, and mostly what they eat—has been huge for Martin, who’s wanted all year to buy lunch at his school back home, which, of course, would be inconceivable: Have you seen U.S. school lunches? Here, at the camp, lunches are prepared fresh from organic ingredients, many grown on site, with focus on health. I met in advance with one of the camp directors and asked that they respect Martin’s dairy and beef allergies, and that he not be permitted to eat any gluten. No problem, they said. The directors reported that, for the first week, Martin had “lunch worries” and needed to be persuaded each day, anew, that in fact he would be fed. At first, he ate tentatively, mostly Nicaragua’s famous rice-and-beans dish, gallo pinto, or even arroz unadorned.

The aftermath of Martin’s octopus, rice, and vegetables on the beach.

After the tentative first steps, Martin started taking advantage of everything offered. I mean, everything!, and that’s brought some slip-ups. Even though I pack healthy snacks, he wants the snacks the camp keeps on hand for all kids, which include popcorn, commercial yucca and plantain chips (fried in who knows what sort of refined vegetable oil), French fries, popsicles with food colorings and refined sugar. I don’t like the snacks aspect but am resisting the urge to make the camp pull back; eating at camp, plus the wide availability of fresh seafood and vegetables in Nicaraguan restaurants (not much pizza or pasta getting in the way), seems to be helping to reduce Martin’s food-related anxiety. I hear less, “Can I eat this? Can I eat that?” and more, “Hey, do they have octopus? How about rice?”

We are, however, in something of a popsicle crisis. Now that Martin has tasty a frozen refined-sugar stick, my homemade frozen-fruit popsicles just aren’t cutting it anymore.

This is a “fancy” breakfast, like we have when guests are eating with us: pancakes and potatoes cooked with shredded vegetables.

The overall picture is that Martin has been eating 93.6% well, and 6.4% sugar and junk food. When I say sugar, I mean those aforementioned popsicles but also potatoes, rice (which also brings arsenic), and fruit. The fruit includes a daily smoothie from our favorite smoothie stand. Martin selects the three fruits he wants (usually pineapple, mango, and lemon), while from behind him I mouth “¡y aguacate!” to the smoothie-maker so that he’ll throw in some avocado, too. Martin professes not to like avocado, so I have to get creative, like sneaking it into a smoothie.

A few weeks ago, I discussed the situation with Martin’s doctor back home. Too much sugar, I confessed. A whole lot of fruit. Smoothies every day.

“You mean fresh, mineral-rich local fruit?” she asked.

“Some of it directly from the fields,” I replied.

“I think he’ll survive.”

Another breakfast, this time plantain-and-egg pancakes with pineapple and raw energy bars that I made from almonds, dates, limes, and shredded coconut.

Forgive me another post on food. I don’t usually hit food twice in a row—I’ll make this one quick.

Many are the challenges to feeding a three-member family when the child is mostly Paleo/low-sal/meaty, the mother is vegan, and the father is primarily pescatarian and prefers salads.

The vegan, who prepares the food, comes last. I’ll pretty much forage the (vegan) scraps of what the other two eat, so let’s take me out of the equation.

Sometimes I can feed Martin and Adrian the same meal, as with the “anything” pasta. Other times, I make a main course for Martin and repurpose it into a salad dish for Adrian. I’ve got quite adept at this repurposing. Add sliced avocado, maybe some fruit and nuts, and voila!, fancy salad.

Yesterday I made the promised white-bean skordalia. (Remember? The cannellini beans I forgot to soak?) For Martin, I scooped a heap of skordalia onto a plate and inserted two dozen raw carrot sticks, which poked out in all directions. I called this creation (which I forgot to photograph) a “moon flower.” Martin removed and ate the carrot sticks, then finished the skordalia with a spoon.

For Adrian, I made the skordalia the major protein in a salad, with pine nuts for flair. I added mixed greens with his favorite dressing—olive oil mixed with chickpea miso—and macadamia nuts and diced cucumber on top. I had fresh strawberries, so I finished dressing the plate with fresh strawberries.

So I’ve discovered that I can make a decent pasta meal out of anything “vegetable” in my refrigerator. Like, virtually anything.

Last night I planned to make white bean skordalia. By the time I discovered that I forgot to advance-soak the cannellini beans, I had only minutes to devise another dinner. I surveyed the kitchen and assembled these ingredients:

->Carrots, with their green tops. I always cook the carrot greens. Once when I was checking out, the supermarket cashier casually snapped off the carrot greens and tossed them in a garbage bin. I promptly commenced a lengthy oration on the benefits of carrot greens.

I prepped the carrots (greens and all) and celery in a vinegar bath, then cut them into pieces and put them in my food processor. October 13, 2011, I wrote a post titled, “Kitchen News: An Update on the Hunt for a Food Processor With Glass Bowl,” which (based on total unique views) is the most popular post ever to grace this blog. Five-and-a-half years later, I am still without a glass food processor. I processed the carrots and celery almost to a paste. Then I chopped the onions and garlic roughly and added them to the food processor.

While the pasta was cooking, I heated a generous amount of oil and fried the finely minced vegetables. When they were almost done, I added onion salt and a scoop of pine nuts.

Finally I drenched the cooked pasta in cold water to prevent mushiness and added it to the veggie pan.

The resulting dinner was pasta coated in lovely crunchy-garlicky bits. Martin said, “Oh yes, this is delicious!” and Adrian ate every last bit from the pan.

Must remember—“night in a pinch” will henceforth be known as “garlic pasta dinner.”

According to “drugs.com,” salicylates (in their synthetic form?) do more than delay food rot:

Salicylates are nonsteroidal anti-inflammatory drugs. They inhibit the synthesis of prostaglandin and other mediators in the process of inflammation and have anti-inflammatory, antipyretic and analgesic properties. Salicylates can be used to reduce fever, pain and inflammation such as in arthritis.

Martin had been having a troublesome few months, as you may know. When Martin is having a tough time, even if he’s sleeping well (which, these days, he almost invariably is), I often find myself awake during the night, fretting. Such was the case that first night in Park City. I woke around 3:30 am (which is 5:30 am in New York, just about when I usually get up) and couldn’t go back to sleep, so I moved to the sofa with my iPad and started reading.

I’m not sure why I felt compelled to navigate directly to salicylates. I’d thought about salicylates once or twice in the distant past and, for whatever reason, not pursued the topic, probably because I was onto some other next big thing. But this occasion, in the wee hours on a Park City sofa, I read a page about salicylate sensitivity, then another. And another. And another. I read about hyperactivity. Anxiety. Sensitivity. Uncontrollable laughter.

I thought, “This sounds like Martin. This sounds a lot like Martin.”

Martin’s diet has been clean for years. We’ve done GAPS, modified GAPS, SCD, and custom variations to account for mitochondrial dysfunction. We’ve made much progress toward heal Martin’s gut; he no longer “postures,” his belly is flat, his bowel movements are works of art. Still, he exhibits physical manifestations that may be food-related, like occasional shiners and visible inflammation. I’ve taken him recently for allergy testing, both traditional and naturopathic. I’ve discovered the beef allergy and a few others, including horses (riding them, not eating them, though there was once an unfortunate incident in South America when Martin ate some jerky after I failed to recognize the local word for “horse”). I avoid what I’m told to avoid.

But I’ve never put Martin on a low-sal diet.

By this time it was 4:30 am. I texted my friend Stacey, “I think Martin might be salicylate-intolerant. I really think I might be onto something.”

Her reply came hours later, when we were already skiing: “I don’t even know what that means, but hey glad you’re getting somewhere.” To the extent one can hear frustration in a text message, I heard some frustration in hers. I know she’s been having an even tougher time with her son, and feeling like they aren’t making much progress toward recovery.

That evening, I texted back, truthfully: “At the moment, I’m getting nowhere. He’s a complete disaster today.” I mean, why did you think I was texting you about salicylates at 4:30 am? “But I’m going to try removing salicylates from his diet and see what happens.”

I couldn’t put my low-sal plan into effect immediately. I’d already spent hundreds of dollars at the Whole Foods Market, stocking us up for the week. I had freeze-dried pineapple (high-sal!), fresh sweet potatoes (high-sal!), Lärabars (dates and almonds, high-sal!), coconut oil (extra high-sal!). Plus, I couldn’t find just one website that compiled all the salicylate contents that I needed to know about. Nori seaweed? Ground flax meal? Kohlrabi? Who could give me these important facts? I spent my evenings, after skiing and cooking, surfing around to put together the most comprehensive list I could. Different sources even disagreed on the salicylate content in some foods, like cauliflower and parsley.

I searched for a low-sal cookbook and finally located one, which needed to be sent from New Zealand. I ordered it immediately.

I returned to the Whole Foods Market and picked up lower-sal safflower oil—the store didn’t have the sunflower oil I was looking for—and white potatoes for breakfast. For the ski week, I managed what I would call “reduced-salicylate” but not “low-salicylate.” Martin had turkey bacon (unacceptable for celery salt and spices) and bison hot dogs (same), plus carrots and other medium-sal veggies. His mountainside snacks were still the nut- and seed-based products I’d brought to Utah or purchased on-site, though I did make an effort to send the cashew (low-sal) versions instead of the almond (high-sal) versions.

Our second-to-last morning in Utah, when I was almost out of food, I made Martin a “breakfast tortilla,” which was peanut butter spread between two almond tortillas and fried. Peanut butter is medium-salicylate, and almonds are high-salicylate, making this breakfast the largest serving of salicylates he’d had all week. Midway through breakfast, Martin started laughing. Laughing so hard he could barely get food into his mouth. Laughing so hard he needed to leave the table to jump. Martin laughs inappropriately, often. But this was of a new magnitude.

I asked him what was going on. He replied, “I don’t know! I can’t stop laughing!”

Uncontrollable laughter. Was this salicylate-related? When Adrian emerged, from the shower, I relayed what had happened. He could also see for himself, as Martin was still laughing. We decided immediately to explore a low-sal diet to the fullest. Adrian said, “I support this. Let me know what you need from me.”

We arrived home late Monday night, January 2. Tuesday morning, I went shopping. This first shopping venture in the low-sal world felt strange. Martin will be eating starchy foods he loves that previously I kept in strict moderation, like potatoes and rice. For cooking, the only plant-based oils I use at home have been raw coconut and extra-virgin oil, both of which are extremely high-sal; now, along with rendered animal fat, I am urged to use sunflower or rice-bran oil, and even (gasp!) the refined forms. Honey, with all its beneficial properties, is out now, even manuka honey. Lower-sal sweeteners are the more refined forms, like sugar cane. (No way. I’ll be sticking to maple syrup and maple sugar, which are allowed.) No more fruit, except papayas, bananas, peeled pears, and peeled golden delicious apples.

Of course, I wonder why Martin is salicylate-sensitive now (if in fact I’m correct). Has he always been this way? Is it new? Will I ever know? Martin is a never-ending series of “why now?”

The cookbook from New Zealand arrived quite promptly, considering the distance it had to travel. I opened it with alacrity, ready to get to work.

. . . And found that virtually every recipe contains (gluten) flour or dairy. Most recipes contain both.